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Invoice Ophthalmologist in Pakistan Karachi –Free Word Template Download with AI

Regulated by the Pakistan Medical Commission (PMC)

INVOICE

Invoice #: KVC-2023-8942

Date: October 24, 2023

Due Date: November 07, 2023

Status: Pending Payment

Bill From (Ophthalmologist)

Dr. Ahmed Raza Khan, FCPS (Ophth)

Senior Consultant Ophthalmologist

Karachi Vision Care Center

Plot 45-B, Block 5, Clifton

Shahrah-e-Faisal, Karachi, Sindh

Pakistan

Phone: +92-21-3587-XXXX

Email: [email protected]

NTN: 1234567-8

Bill To (Patient)

Mr. Bilal Ahmed Siddiqui

House #12, Street 4, DHA Phase 6

Karachi, Sindh

Pakistan

Phone: +92-300-1234567

CNIC: 35202-XXXXXXX-X

Insurance: Al-Falah General Insurance (Policy #AF-9988)

Service Context: This invoice represents the professional fees and associated costs for ophthalmological services rendered at our clinic in Karachi, Pakistan. The treatment plan was formulated following a comprehensive eye examination, including slit-lamp biomicroscopy and retinal imaging, conducted by our board-certified Ophthalmologist. All procedures adhere to the standards set by the Pakistan Medical Commission and local healthcare regulations in Sindh.

# Description of Ophthalmology Services Quantity Unit Price (PKR) Total (PKR)
1 Consultation Fee (Specialist Ophthalmologist)
Initial comprehensive eye evaluation, history taking, and diagnosis by Dr. Ahmed Raza Khan.
1 3,500.00 3,500.00
2 Diagnostic Imaging: OCT Scan
Optical Coherence Tomography for retinal layer analysis and macular assessment.
1 4,000.00 4,000.00
3 Diagnostic Imaging: Fundus Photography
High-resolution digital imaging of the retina for diabetic retinopathy screening.
1 2,500.00 2,500.00
4 Phacoemulsification Surgery (Cataract)
Micro-incision cataract surgery with ultrasound emulsification. Includes surgeon fee, anesthesia, and facility charges.
1 45,000.00 45,000.00
5 Intraocular Lens (IOL) Implant
Premium Toric IOL (Single Vision) to correct astigmatism. Imported medical device.
1 35,000.00 35,000.00
6 Post-Operative Medication Kit
Includes antibiotic drops, anti-inflammatory steroids, and lubricants as prescribed by the Ophthalmologist.
1 4,500.00 4,500.00
7 Follow-up Consultation
Post-surgical review to monitor healing and intraocular pressure.
2 2,000.00 4,000.00
Subtotal: PKR 98,500.00
Discount (Insurance Coverage): - PKR 40,000.00
Net Amount: PKR 58,500.00
Sales Tax (17% - Govt of Pakistan): PKR 9,945.00
Grand Total Due: PKR 68,445.00

Payment Instructions

Please make payment within 14 days of the invoice date. Payments can be made via bank transfer, cash, or credit card at our Karachi clinic.

Bank Name: Habib Bank Limited (HBL)
Branch: Clifton Branch, Karachi
Account Title: Karachi Vision Care Center (Pvt) Ltd
Account Number: 0123-4567890-00
IBAN: PK36HABB01234567890000
SWIFT Code: HABBPKKA

Terms and Conditions

  • This invoice is issued in accordance with the tax laws of Pakistan. The Sales Tax is calculated at the prevailing rate of 17%.
  • All ophthalmological procedures performed by our Ophthalmologist are subject to standard medical risks. Informed consent was obtained prior to surgery.
  • Insurance claims must be submitted with this original invoice and the detailed medical report within 30 days.
  • Late payments may incur a penalty of 2% per month on the outstanding balance.
  • For any discrepancies regarding this invoice, please contact our billing department in Karachi immediately.

Authorized Signatory

Dr. Ahmed Raza Khan

Lead Ophthalmologist

Patient Acknowledgement

Signature & Date

Karachi Vision Care Center | Plot 45-B, Block 5, Clifton, Karachi, Pakistan

Phone: +92-21-3587-XXXX | Email: [email protected]

Thank you for trusting our Ophthalmology services.

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